Ivan Stewart Rosenthal, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC1248 Issued in FL

Practice address

23 NE 44TH St
Oakland Park, FL 33334-1437

Phone

(561) 487-0818

Fax

(561) 487-9030

NPI assigned

Jun 22, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290556800000",
    "number": "1821034042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9858 GLADES RD",
            "address_2": "STE D-2",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334343982",
            "telephone_number": "561-487-0818",
            "fax_number": "561-487-9030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 NE 44TH ST",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333341437",
            "telephone_number": "561-487-0818",
            "fax_number": "561-487-9030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENTHAL",
        "first_name": "IVAN",
        "middle_name": "STEWART",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2010-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC1248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "620511900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "410027418",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenia Rojas Gongora, FNP
• Victoria Adriana Rojas
• Sandra Romain, MD
• John Romano
• Lisnet Rosell Herrada
• Mitchell Rosenwald, PHD, LCSW
• Jennifer Lyn Rosidor
• Daryl Jon Roy, DMD
• Royal Grace DME LLC
• Royal Palm Beach Rehab Corp (Action Physical Therapy)

• Optometrist in Oakland Park, FL
• Providers in Oakland Park, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.